Factors Associated With Successful Outcomes Following Arthroscopic Discopexy for Symptomatic Disc Displacement

Abstract

Background Symptomatic disc displacement (SDD) is a common temporomandibular joint disorder, with arthroscopic discopexy being one of the treatment options that offers the advantages of a minimally invasive approach. Purpose The purpose was to evaluate factors associated with favorable outcomes after mattress-loop technique (Yang's technique) for arthroscopic discopexy in subjects with SDD. Study Design, Setting, and Sample This prospective cohort study was conducted at a tertiary care center (Clínica Bupa Santiago). Patients presenting between 2022 and 2024 with SDD who required arthroscopic discopexy were enrolled. Exclusion criteria included missing preoperative data or unavailable preoperative magnetic resonance imaging (MRI). Predictor Variable The predictor variable was a set of heterogenous variables categorized as demographic, perioperative, or imaging. Main Outcome Variables The main outcome variable was therapeutic effect measured using (1) visual analog scale to assess pain and (2) maximal incisal opening (MIO). The secondary outcome was radiographic, measured using disc stability assessed on 6-month MRI based on disc position. All variables were measured at baseline and at 6 months postoperatively. Covariates Not applicable. Analyses Data were analyzed using descriptive and inferential statistics, a statistical significance was set at P value < .05. Mixed-effects regression models with a random intercept for patient to account for correlation between joints within the same individual were performed for changes in pain, MIO, and disc position stability. Results A total of 218 joints from 141 subjects were included. At 6 months, pain decreased from a mean of 5.53 ± 2.42 to 0.81 ± 1.60 (Δ = 4.72, P < .05) and MIO increased from 31.29 ± 9.13 mm to 38.52 ± 4.61 mm (Δ = 7.23 mm, P